NPI | 1376520114 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA G52928) |
Additional Taxonomies | 174400000X Specialist (Licence: CA G52928) |
2085R0202X Radiology, Diagnostic Radiology (Licence: CA G52928) | |
Enumeration Date | 2005-12-22 |
Last Update Date | 2024-05-15 |