NPI | 1720053036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 50837) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 47684) |
2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME104506) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: NE 26628) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: WY TL1737) | |
Enumeration Date | 2006-02-21 |
Last Update Date | 2013-11-11 |