| NPI | 1851489694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200900166) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036.119872) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 200900166) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2016-10-04 |