NPI | 1306112057 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A128627) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301500421) |
Enumeration Date | 2012-03-27 |
Last Update Date | 2020-06-09 |