NPI | 1407832587 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 31701) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 31701) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME118684) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 1718) | |
Enumeration Date | 2005-12-20 |
Last Update Date | 2020-09-03 |