NPI | 1245218171 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00029725) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-12309) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD00029725) | |
Enumeration Date | 2005-12-30 |
Last Update Date | 2019-04-17 |