NPI | 1417385402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.147693) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX S6750) |
Enumeration Date | 2013-10-29 |
Last Update Date | 2023-07-25 |