NPI | 1225141328 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME92656) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL me92656) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2023020198) | |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: FL ME92656) | |
Enumeration Date | 2006-08-16 |
Last Update Date | 2023-07-18 |