NPI | 1861428989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: WA MD00043926) |
Additional Taxonomies | 2085N0904X Radiology Nuclear Radiology (Licence: WA MD00043926) |
Enumeration Date | 2006-06-23 |
Last Update Date | 2020-09-24 |