NPI | 1487681599 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: ND 4703) |
Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: ND 4703) |
2085R0204X Radiology Vascular & Interventional Radiology (Licence: ND 4703) | |
Enumeration Date | 2006-06-26 |
Last Update Date | 2012-07-18 |