NPI | 1033417571 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0073335) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MN 62846) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MN 62846) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 62846) | |
Enumeration Date | 2011-03-08 |
Last Update Date | 2024-07-31 |