NPI | 1982867420 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MI 4301100455) |
Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: TX BP10034816) |
2085R0204X Radiology Vascular & Interventional Radiology (Licence: GA 002928) | |
208D00000X General Practice (Licence: MI 4301100455) | |
Enumeration Date | 2008-07-04 |
Last Update Date | 2015-06-09 |