NPI | 1295787059 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR 26620) |
Additional Taxonomies | 174400000X Specialist (Licence: OR 26620) |
Enumeration Date | 2006-05-17 |
Last Update Date | 2008-01-15 |