NPI | 1245220037 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PR 5340) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PR 5340) |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: PR 5340) | |
Enumeration Date | 2005-10-24 |
Last Update Date | 2021-08-15 |