NPI | 1376700591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: LA MD.206162) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 13254) |
Enumeration Date | 2008-05-16 |
Last Update Date | 2020-02-11 |