| NPI | 1972952000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301502698) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301109648) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2026-04-02 |