NPI | 1790727188 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G21552) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA G21552) |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA G21552) | |
Enumeration Date | 2006-06-12 |
Last Update Date | 2014-05-08 |