NPI | 1902966856 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 6777) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 42515) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 42515) | |
Enumeration Date | 2006-12-11 |
Last Update Date | 2012-10-11 |