NPI | 1386818516 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60367833) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: WA 60367833) |
2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD205146) | |
Enumeration Date | 2008-04-18 |
Last Update Date | 2024-08-29 |