NPI | 1053330639 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: SC 35273) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101245727) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2019-04-05 |