NPI | 1174548051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NM 89-144) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA G73711) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2016-06-06 |