NPI | 1396970562 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60551342) |
Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WA MD60551342) |
207U00000X Nuclear Medicine (Licence: CO DR.0055346) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD172582) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0055346) | |
Enumeration Date | 2009-05-18 |
Last Update Date | 2018-06-29 |