NPI | 1851562540 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 41825) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.091510) |
174400000X Specialist (Licence: KY 41825) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01062470A) | |
Enumeration Date | 2008-03-20 |
Last Update Date | 2024-06-13 |