NPI | 1194760876 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101254737) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D68016) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MD D68016) | |
Enumeration Date | 2006-06-18 |
Last Update Date | 2013-10-02 |