NPI | 1205095460 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60453057) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OR MD167073) |
2085N0700X Radiology, Neuroradiology (Licence: WA MD60453057) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD167073) | |
Enumeration Date | 2008-06-03 |
Last Update Date | 2024-08-29 |