NPI | 1891832184 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102202327) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: VA 0102202327) |
2085R0202X Radiology, Diagnostic Radiology (Licence: HI DOS-879) | |
Enumeration Date | 2007-01-30 |
Last Update Date | 2014-02-07 |