NPI | 1619935590 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A101516) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA A101516) |
2085R0202X Radiology, Diagnostic Radiology (Licence: CA A101516) | |
Enumeration Date | 2006-05-02 |
Last Update Date | 2011-08-15 |