NPI | 1528058237 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD417753) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD31039) |
2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD417753) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: DC MD31039) | |
Enumeration Date | 2005-10-24 |
Last Update Date | 2021-01-28 |