NPI | 1689682015 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61039212) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA F5317) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2020-06-03 |