NPI | 1215340047 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A136546) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA a136546) |
Enumeration Date | 2014-06-10 |
Last Update Date | 2023-12-12 |