NPI | 1790987071 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: LA MD.202842) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200700455) |
Enumeration Date | 2007-05-31 |
Last Update Date | 2010-03-04 |