| NPI | 1932122843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD34308) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 048920) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 34308) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 48920) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2018-02-22 |