NPI | 1972858652 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 56996) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 24990) |
208600000X Surgery (Licence: ND TRL 12380) | |
Enumeration Date | 2012-07-18 |
Last Update Date | 2018-04-05 |