NPI | 1376548222 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 33848) |
Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NC 33848) |
2085N0700X Radiology, Neuroradiology (Licence: NC 33848) | |
Enumeration Date | 2005-06-16 |
Last Update Date | 2020-10-01 |