NPI | 1003344185 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085N0700X (Licence: WV 35464) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WV 35464) |
Enumeration Date | 2017-06-01 |
Last Update Date | 2025-08-06 |