NPI | 1497795595 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: UT 162875-1205) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 162875-1205) |
2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-8431) | |
Enumeration Date | 2006-06-07 |
Last Update Date | 2012-09-06 |