NPI | 1366599169 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2018-01312) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 42145) |
2085R0202X Radiology, Diagnostic Radiology (Licence: KY 42145) | |
Enumeration Date | 2007-01-04 |
Last Update Date | 2020-09-13 |