NPI | 1225357718 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D0082037) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0082037) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: DC MD210012388) | |
Enumeration Date | 2010-05-24 |
Last Update Date | 2023-11-20 |