NPI | 1376993063 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CA A186634) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A186634) |
Enumeration Date | 2016-06-14 |
Last Update Date | 2023-07-17 |