NPI | 1225212491 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 51786) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4301088299) |
Enumeration Date | 2007-12-24 |
Last Update Date | 2016-12-16 |