NPI | 1639133200 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 12834) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NV 12834) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD00044060) | |
Enumeration Date | 2006-04-12 |
Last Update Date | 2024-09-17 |