NPI | 1194721092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2002-00375) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 679) |
Enumeration Date | 2005-06-24 |
Last Update Date | 2017-12-20 |