| NPI | 1881012912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 008341) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 146771) |
| Enumeration Date | 2014-04-05 |
| Last Update Date | 2025-09-09 |