NPI | 1033537857 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 312752) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME144236) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 76554) | |
Enumeration Date | 2014-03-29 |
Last Update Date | 2024-09-03 |