NPI | 1639268659 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101046659) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: VA 0101046659) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2009-07-28 |