NPI | 1851704514 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 308629) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MT 206057) |
Enumeration Date | 2014-06-10 |
Last Update Date | 2023-03-30 |