NPI | 1679564892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME109958) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: IA 32726) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA 32726) | |
Enumeration Date | 2005-11-04 |
Last Update Date | 2012-07-12 |