NPI | 1003851726 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2018-0643) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101281884) |
Enumeration Date | 2006-06-17 |
Last Update Date | 2024-06-13 |