NPI | 1265403414 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 22256) |
Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: AZ 22256) |
2085U0001X Radiology Diagnostic Ultrasound (Licence: AZ 22256) | |
2085B0100X Radiology Body Imaging (Licence: AZ 22256) | |
Enumeration Date | 2006-01-27 |
Last Update Date | 2013-02-27 |