NPI | 1326042763 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: KY 34712) |
Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: KY 34712) |
2085R0202X Radiology Diagnostic Radiology (Licence: KY 34712) | |
Enumeration Date | 2005-06-13 |
Last Update Date | 2016-06-28 |