NPI | 1063613735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M9341) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 37263) |
2085R0202X Radiology, Diagnostic Radiology (Licence: OK 26184) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: IA R-6954) | |
Enumeration Date | 2007-05-30 |
Last Update Date | 2021-10-08 |