NPI | 1205183951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A121928) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A121928) |
Enumeration Date | 2012-08-13 |
Last Update Date | 2022-02-02 |