| NPI | 1861878837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NY 308512) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 308512) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NY 308512) | |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2023-08-18 |