NPI | 1295914711 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: WA MD60267813) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60267813) |
Enumeration Date | 2007-11-01 |
Last Update Date | 2012-06-21 |