NPI | 1629259957 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101251881) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-052398) |
Enumeration Date | 2007-11-15 |
Last Update Date | 2012-06-13 |