| NPI | 1902984776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MT MED-PHYS-LIC-43501) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A78906) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-09-22 |