NPI | 1326129453 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301077390) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MI 4301077390) |
2085R0202X Radiology, Diagnostic Radiology (Licence: GU M-2189) | |
Enumeration Date | 2006-10-17 |
Last Update Date | 2019-12-09 |