NPI | 1114149788 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 30580) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2005-00415) |
2085N0904X Radiology, Nuclear Radiology (Licence: SC 30580) | |
Enumeration Date | 2007-05-03 |
Last Update Date | 2014-02-14 |