NPI | 1841553088 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60837429) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD188795) |
2085N0700X Radiology, Neuroradiology (Licence: OR MD188795) | |
2085N0700X Radiology, Neuroradiology (Licence: WA MD60837429) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2017008637) | |
Enumeration Date | 2012-06-22 |
Last Update Date | 2024-04-25 |