NPI | 1376578609 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR MD153946) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 227646) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 227646) | |
Enumeration Date | 2006-07-12 |
Last Update Date | 2023-11-17 |