NPI | 1467436394 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 74590) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0083946) |
2085N0700X Radiology, Neuroradiology (Licence: MD D0083946) | |
Enumeration Date | 2005-12-05 |
Last Update Date | 2024-05-09 |