NPI | 1245201268 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX F2871) |
Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: TX F2871) |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: TX F2871) | |
Enumeration Date | 2006-01-28 |
Last Update Date | 2010-02-15 |