NPI | 1699204081 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX U3877) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A162300) |
Enumeration Date | 2017-06-08 |
Last Update Date | 2023-05-18 |