| NPI | 1952331589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: KS 04-29366) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NE 22074) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 429366) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2013-04-10 |