NPI | 1659574150 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101245789) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101245789) |
Enumeration Date | 2007-06-11 |
Last Update Date | 2024-03-12 |