NPI | 1497101489 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX R8712) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R8712) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 65687) | |
Enumeration Date | 2016-05-09 |
Last Update Date | 2023-04-25 |