NPI | 1124099213 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 32890) |
Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: AZ 32890) |
2085B0100X Radiology, Body Imaging (Licence: AZ 32890) | |
Enumeration Date | 2006-01-28 |
Last Update Date | 2016-11-09 |