NPI | 1861619934 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: KY 45364) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301088536) |
2085R0202X Radiology, Diagnostic Radiology (Licence: KY 45364) | |
Enumeration Date | 2007-04-19 |
Last Update Date | 2012-11-26 |