NPI | 1114929965 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0030871) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 10357) |
Enumeration Date | 2005-08-11 |
Last Update Date | 2007-11-13 |