NPI | 1710271515 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 263031) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 247978) |
Enumeration Date | 2011-06-09 |
Last Update Date | 2016-03-03 |