NPI | 1073715884 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX L6438) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: RI LP01185) |
Enumeration Date | 2007-06-04 |
Last Update Date | 2018-07-11 |