NPI | 1235330754 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60341376) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: WA MD60341376) |
2085N0700X Radiology, Neuroradiology (Licence: OR MD165183) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD165183) | |
Enumeration Date | 2007-05-31 |
Last Update Date | 2024-08-30 |