NPI | 1306233911 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME145491) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 304368) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD476844) | |
Enumeration Date | 2015-04-21 |
Last Update Date | 2024-10-27 |