NPI | 1689732091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 30781) |
Additional Taxonomies | 174400000X Specialist (Licence: FL ME30781) |
Enumeration Date | 2006-12-05 |
Last Update Date | 2011-12-14 |