NPI | 1063400919 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 25221) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: IA 25221) |
Enumeration Date | 2005-10-13 |
Last Update Date | 2007-12-18 |