NPI | 1831180082 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME86904) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD039114L) |
Enumeration Date | 2005-11-04 |
Last Update Date | 2018-07-31 |