| NPI | 1861684342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD 441416) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD441416) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2026-03-10 |