NPI | 1467477109 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 37969) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 21342) |
2085R0202X Radiology, Diagnostic Radiology (Licence: WY 7650A) | |
Enumeration Date | 2006-07-13 |
Last Update Date | 2015-09-16 |