NPI | 1124220371 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME101543) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2009-00390) |
Enumeration Date | 2007-06-01 |
Last Update Date | 2019-05-30 |