NPI | 1033202536 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX U5598) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0026240) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WY 10974A) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0044137) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NE 30092) | |
Enumeration Date | 2006-10-02 |
Last Update Date | 2024-08-19 |