NPI | 1528392321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 051271) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CT 051271) |
Enumeration Date | 2009-09-25 |
Last Update Date | 2015-05-31 |