NPI | 1164869293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 55131) |
Additional Taxonomies | 208600000X Surgery (Licence: RI LP02792) |
Enumeration Date | 2013-05-30 |
Last Update Date | 2022-08-29 |