NPI | 1013018159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200101032) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 200101032) |
2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101271324) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: SC 85214) | |
Enumeration Date | 2006-09-25 |
Last Update Date | 2024-04-17 |