NPI | 1396761631 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA G86348) |
Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CA G86348) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2019-05-21 |