| NPI | 1972761229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D0075861) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD041344) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0075861) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: DC MD041344) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2019-07-22 |