| NPI | 1932296985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: UT 5119518-1205) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: UT 5119518-1205) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2012-06-05 |