NPI | 1124024062 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G83923) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA G83923) |
Enumeration Date | 2005-06-24 |
Last Update Date | 2015-07-29 |