NPI | 1982604666 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: UT 174591-1205) |
Additional Taxonomies | 2085N0904X Radiology Nuclear Radiology (Licence: UT 174591-1205) |
Enumeration Date | 2005-07-26 |
Last Update Date | 2019-02-26 |