NPI | 1477540961 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: SC 20176) |
Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: SC 20176) |
Enumeration Date | 2005-09-30 |
Last Update Date | 2016-09-14 |