NPI | 1205082401 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CA A104307) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A104307) |
Enumeration Date | 2008-08-07 |
Last Update Date | 2024-06-08 |