NPI | 1841302007 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00048235) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 044452) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2012-01-10 |