NPI | 1790762946 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD00030288) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00030288) |
Enumeration Date | 2005-12-29 |
Last Update Date | 2018-05-01 |