NPI | 1467471284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: UT 291097-1205) |
Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: UT 291097-1205) |
2085D0003X Radiology Diagnostic Neuroimaging (Licence: UT 291097-1205) | |
2085R0202X Radiology Diagnostic Radiology (Licence: UT 291097-1205) | |
2085R0202X Radiology Diagnostic Radiology (Licence: NV 11176) | |
Enumeration Date | 2006-07-19 |
Last Update Date | 2021-08-12 |