NPI | 1003680174 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2025-00766) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 233344990000) |
Enumeration Date | 2023-11-09 |
Last Update Date | 2025-06-11 |