NPI | 1962406710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 19804) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 20179) |
2085R0202X Radiology, Diagnostic Radiology (Licence: IA 26083) | |
Enumeration Date | 2005-06-09 |
Last Update Date | 2010-04-21 |