NPI | 1326336942 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R4506) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60340415) |
Enumeration Date | 2011-07-17 |
Last Update Date | 2019-02-21 |