NPI | 1609139591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A156014) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A156014) |
Enumeration Date | 2012-06-17 |
Last Update Date | 2023-11-27 |