NPI | 1033221080 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX G8619) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: TX G82629) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX G8619) | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2018-11-06 |