NPI | 1174542179 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 48785) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 223682) |
Enumeration Date | 2006-07-19 |
Last Update Date | 2017-01-03 |