NPI | 1962464958 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX K5382) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: TX K5382) |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: TX K5382) | |
2085N0700X Radiology, Neuroradiology (Licence: TX K5382) | |
Enumeration Date | 2006-04-05 |
Last Update Date | 2012-08-15 |