NPI | 1609865948 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 6006) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 4985210-1205) |
2085R0202X Radiology, Diagnostic Radiology (Licence: WY 4597A) | |
Enumeration Date | 2005-10-19 |
Last Update Date | 2014-11-26 |