NPI | 1710320569 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA OS019015) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C7-0005338) |
2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS019015) | |
Enumeration Date | 2013-04-11 |
Last Update Date | 2024-09-04 |