NPI | 1114973013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD27476) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 31436) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL MD27476) | |
Enumeration Date | 2006-05-25 |
Last Update Date | 2016-12-05 |