| NPI | 1871740332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 071219) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 48791) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 071219) | |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2020-02-19 |