NPI | 1407871163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD15909) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00025311) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2024-07-05 |