NPI | 1073574349 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SD 1629) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 3100A) |
Enumeration Date | 2006-03-28 |
Last Update Date | 2012-08-06 |