NPI | 1548525744 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 55604) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: AZ 55604) |
Enumeration Date | 2012-07-13 |
Last Update Date | 2022-06-29 |