NPI | 1356568810 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A93239) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 30268) |
2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101271610) | |
Enumeration Date | 2007-04-19 |
Last Update Date | 2021-06-09 |