NPI | 1104829902 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD063610L) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD063610L) |
Enumeration Date | 2005-05-24 |
Last Update Date | 2023-12-01 |