NPI | 1518167725 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO 52005) |
Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: AZ 45978) |
2085R0202X Radiology Diagnostic Radiology (Licence: AZ 45978) | |
Enumeration Date | 2007-07-25 |
Last Update Date | 2015-01-19 |