NPI | 1700165453 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 54351) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 105652) |
Enumeration Date | 2011-08-12 |
Last Update Date | 2011-09-20 |