NPI | 1376591594 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C28354) |
Additional Taxonomies | 174400000X Specialist (Licence: CA C28354) |
2085N0904X Radiology, Nuclear Radiology (Licence: CA C28354) | |
Enumeration Date | 2006-05-04 |
Last Update Date | 2007-11-27 |