NPI | 1245291822 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 42431) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 42431) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301056320) | |
Enumeration Date | 2006-03-31 |
Last Update Date | 2024-04-26 |