| NPI | 1851619522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D0081214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD MT197207) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2016-11-22 |