NPI | 1336374305 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME109220) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CT 047375) |
2085B0100X Radiology, Body Imaging (Licence: FL ME109220) | |
Enumeration Date | 2009-05-20 |
Last Update Date | 2015-07-16 |