NPI | 1548264286 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 17157) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 16641) |
2085R0202X Radiology, Diagnostic Radiology (Licence: IA 26079) | |
Enumeration Date | 2005-06-10 |
Last Update Date | 2007-07-08 |