NPI | 1578726683 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: ID M-12384) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 104451) |
2085R0202X Radiology Diagnostic Radiology (Licence: MN 52314) | |
Enumeration Date | 2008-07-08 |
Last Update Date | 2018-01-10 |