NPI | 1841236510 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 4495A) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 40210) |
2085R0202X Radiology, Diagnostic Radiology (Licence: NE 21254) | |
Enumeration Date | 2006-06-21 |
Last Update Date | 2007-07-09 |