| NPI | 1871769034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA 60718032) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A110481) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2019-05-21 |