NPI | 1023499878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301107556) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301107556) |
Enumeration Date | 2015-06-17 |
Last Update Date | 2023-11-20 |