NPI | 1396794350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD 60551281) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 057533) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2016-01-12 |