NPI | 1255325262 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301104034) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 205707) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301104034) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 1833495) | |
Enumeration Date | 2005-09-06 |
Last Update Date | 2022-07-29 |