NPI | 1710980677 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CA A105121) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A105121) |
Enumeration Date | 2005-05-24 |
Last Update Date | 2019-06-04 |