NPI | 1538358205 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 203735) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M6407) |
Enumeration Date | 2007-10-18 |
Last Update Date | 2015-01-11 |