NPI | 1265416861 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 19469) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME64505) |
2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 19469) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 30133) | |
Enumeration Date | 2005-12-06 |
Last Update Date | 2024-04-15 |