NPI | 1225458300 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 73472) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 62973) |
Enumeration Date | 2014-04-16 |
Last Update Date | 2020-09-01 |