NPI | 1518948561 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2008-01123) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 31804) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SC 31804) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2008-01123) | |
Enumeration Date | 2005-11-08 |
Last Update Date | 2017-12-20 |