NPI | 1699753665 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G82197) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NV 8228) |
Enumeration Date | 2006-01-09 |
Last Update Date | 2012-08-30 |