NPI | 1700981966 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60209727) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: WA MD60209727) |
2085R0202X Radiology, Diagnostic Radiology (Licence: NH RT 1621) | |
Enumeration Date | 2006-09-13 |
Last Update Date | 2017-04-12 |