NPI | 1003827007 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 29957) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 46267) |
Enumeration Date | 2006-08-11 |
Last Update Date | 2022-10-06 |