| NPI | 1932213204 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL OS18237) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 36113813) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 02003492A) | |
| Enumeration Date | 2006-08-17 | 
| Last Update Date | 2022-09-27 |