NPI | 1194795732 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 43425) |
Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MA 43425) |
Enumeration Date | 2006-01-25 |
Last Update Date | 2007-07-08 |