NPI | 1417111501 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301086265) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MI 4301086265) |
Enumeration Date | 2008-07-17 |
Last Update Date | 2012-03-28 |