NPI | 1881719334 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 23978) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: TX M3217) |
2085R0202X Radiology, Diagnostic Radiology (Licence: IA 37456) | |
Enumeration Date | 2007-03-20 |
Last Update Date | 2010-02-01 |