NPI | 1285630277 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 31146) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 33698) |
2085R0202X Radiology, Diagnostic Radiology (Licence: IA 27627) | |
Enumeration Date | 2005-06-23 |
Last Update Date | 2013-12-19 |