NPI | 1437403193 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME 114327) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 114327) |
2085R0202X Radiology, Diagnostic Radiology (Licence: FL TRN 14062) | |
Enumeration Date | 2012-11-02 |
Last Update Date | 2023-08-10 |