NPI | 1124293568 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME106416) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 248347-1) |
Enumeration Date | 2008-04-28 |
Last Update Date | 2012-04-20 |