NPI | 1700413689 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SC MMD.85708) |
Additional Taxonomies | 208600000X Surgery (Licence: FL TRN30783) |
Enumeration Date | 2020-03-23 |
Last Update Date | 2024-10-21 |