NPI | 1689718611 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101241063) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101241063) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME167210) | |
Enumeration Date | 2007-02-15 |
Last Update Date | 2024-11-19 |