| NPI | 1942611223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL 44393) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 55919) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2023-06-28 |