NPI | 1366554412 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD60002838) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60002838) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2018-10-11 |