NPI | 1124178405 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 059028) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT049745) |
Enumeration Date | 2007-01-11 |
Last Update Date | 2019-05-06 |