NPI | 1164696456 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME106107) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD037129) |
Enumeration Date | 2008-04-17 |
Last Update Date | 2016-04-11 |