NPI | 1366521734 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 44667) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A87282) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME101199) | |
Enumeration Date | 2006-11-04 |
Last Update Date | 2017-10-24 |