NPI | 1558584235 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 12484) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 5414497-1205) |
2085B0100X Radiology, Body Imaging (Licence: MT 12484) | |
Enumeration Date | 2007-04-11 |
Last Update Date | 2015-05-29 |