NPI | 1609805142 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SC 21627) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 20-21627) |
Enumeration Date | 2006-06-30 |
Last Update Date | 2020-11-09 |