NPI | 1811125511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301102338) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX BP20034184) |
Enumeration Date | 2009-07-01 |
Last Update Date | 2019-08-20 |