NPI | 1184657579 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 22550) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 20531) |
2085R0202X Radiology, Diagnostic Radiology (Licence: WY 7648A) | |
Enumeration Date | 2006-07-08 |
Last Update Date | 2018-04-11 |