NPI | 1336139351 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G16037) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA G16037) |
2085N0904X Radiology, Nuclear Radiology (Licence: CA G16037) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA G16037) | |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA G16037) | |
Enumeration Date | 2005-10-21 |
Last Update Date | 2015-02-16 |