NPI | 1134200363 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D68263) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MI 4301078761) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301078761) | |
Enumeration Date | 2006-10-17 |
Last Update Date | 2013-02-07 |