NPI | 1043607690 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T0216) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX T0216) |
Enumeration Date | 2015-04-22 |
Last Update Date | 2025-06-07 |