| NPI | 1932169794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: MI 4301059588) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301059588) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2020-10-21 |