NPI | 1346209889 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD25686) |
Additional Taxonomies | 174400000X Specialist (Licence: WA MD00043603) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR MD25686) | |
Enumeration Date | 2006-03-22 |
Last Update Date | 2015-11-10 |