NPI | 1285122341 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: KY TP078) |
Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: TX BP20066772) |
208600000X Surgery (Licence: TX BP10062891) | |
Enumeration Date | 2018-04-24 |
Last Update Date | 2024-06-06 |