NPI | 1932396116 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A97040) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD441027) |
2085R0202X Radiology, Diagnostic Radiology (Licence: CA A97040) | |
Enumeration Date | 2007-10-01 |
Last Update Date | 2024-04-05 |