| NPI | 1952477929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: ID M-17359) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: WI 65310) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WI 65310) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: WI 65310) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-01-10 |