| NPI | 1922323484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD456194) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA 1922323484) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL 150594) | |
| Enumeration Date | 2010-03-28 |
| Last Update Date | 2025-09-15 |