NPI | 1154315083 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 028558) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: GA 028558) |
2085N0904X Radiology, Nuclear Radiology (Licence: GA 028558) | |
2085P0229X Radiology, Pediatric Radiology (Licence: GA 028558) | |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: GA 028558) | |
Enumeration Date | 2005-09-07 |
Last Update Date | 2012-06-21 |