| NPI | 1932337979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX Q4283) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 250306) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q4283) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2024-08-08 |