NPI | 1801215868 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VT 042-0015105) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME147398) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME147398) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 315454) | |
Enumeration Date | 2014-04-07 |
Last Update Date | 2022-05-18 |