| NPI | 1881950749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2023006377) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A130764) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2017-00825) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 326254) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2025-03-17 |