NPI | 1265645964 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M3220) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: TX M3220) |
Enumeration Date | 2007-05-08 |
Last Update Date | 2019-06-19 |