| NPI | 1992977342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A95976) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A95976) |
| 208800000X Urology (Licence: CA A95976) | |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2021-06-28 |