NPI | 1417480443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME160492) |
Additional Taxonomies | 208D00000X General Practice (Licence: NY 296412) |
Enumeration Date | 2017-04-06 |
Last Update Date | 2023-03-24 |