NPI | 1275503609 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OR 21811) |
Additional Taxonomies | 174400000X Specialist (Licence: OR 21811) |
Enumeration Date | 2006-01-26 |
Last Update Date | 2019-11-08 |