NPI | 1134566102 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042-0014254) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT-203745) |
Enumeration Date | 2013-05-30 |
Last Update Date | 2019-04-09 |