NPI | 1053391318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO R5N35) |
Additional Taxonomies | 174400000X Specialist (Licence: MO R5N35) |
Enumeration Date | 2006-01-20 |
Last Update Date | 2019-11-15 |