| NPI | 1851325245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NC 2008-00795) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NY 134771) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2014-03-25 |