NPI | 1932208568 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G88069) |
Additional Taxonomies | 174400000X Specialist |
2085R0202X Radiology, Diagnostic Radiology (Licence: NY 134786-1) | |
Enumeration Date | 2006-09-21 |
Last Update Date | 2010-10-08 |