NPI | 1205815107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA G75600) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NV 8171) |
Enumeration Date | 2006-01-10 |
Last Update Date | 2014-01-23 |