| NPI | 1881744480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A114761) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 277245) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A114761) | |
| 2085N0700X Radiology, Neuroradiology (Licence: NY 277245) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2024-06-27 |