| NPI | 1952515553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR MD29074) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA a89260) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA a89260) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2023-01-17 |