NPI | 1720064629 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 40737) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25024) |
2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36604) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17655) | |
Enumeration Date | 2005-12-22 |
Last Update Date | 2017-04-07 |