| NPI | 1932337342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO DR.0055232) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: WY 10153A) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NE 1335) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2022-03-18 |