NPI | 1326401514 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 71577) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME150314) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME150314) | |
Enumeration Date | 2016-04-04 |
Last Update Date | 2024-11-21 |