NPI | 1689652653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G73152) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 71313) |
Enumeration Date | 2006-01-09 |
Last Update Date | 2016-08-05 |