NPI | 1467529701 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 052032) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: CT 052032) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MA 221631) | |
Enumeration Date | 2006-11-30 |
Last Update Date | 2022-09-26 |