NPI | 1568468817 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 24148) |
Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NC 24148) |
Enumeration Date | 2005-06-22 |
Last Update Date | 2007-07-08 |