NPI | 1043714413 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS16404) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS16404) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL OS16404) | |
Enumeration Date | 2018-03-21 |
Last Update Date | 2024-06-19 |