NPI | 1720044183 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G82141) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CA G82141) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: ND 16266) | |
Enumeration Date | 2006-04-25 |
Last Update Date | 2023-12-21 |