NPI | 1629212055 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME137984) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME137984) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 239045) | |
Enumeration Date | 2009-04-29 |
Last Update Date | 2024-01-03 |