NPI | 1578698411 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA c55928) |
Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: CA c55928) |
Enumeration Date | 2007-02-22 |
Last Update Date | 2021-11-29 |