NPI | 1104144906 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101260314) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: DC MD045211) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D83371) | |
208D00000X General Practice (Licence: NE 26326) | |
Enumeration Date | 2010-05-04 |
Last Update Date | 2022-11-30 |