NPI | 1487712402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: VA 0101045752) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0023674) |
Enumeration Date | 2006-12-04 |
Last Update Date | 2007-07-08 |