NPI | 1841255759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 055937) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 05593) |
Enumeration Date | 2006-04-20 |
Last Update Date | 2022-12-01 |