NPI | 1023088606 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101055481) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA 6414E) |
2085R0202X Radiology, Diagnostic Radiology (Licence: LA R2215) | |
Enumeration Date | 2006-01-25 |
Last Update Date | 2007-07-08 |