NPI | 1063416469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00025808) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD12469) |
Enumeration Date | 2005-06-13 |
Last Update Date | 2012-09-12 |