NPI | 1043669070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101273821) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 31124) |
Enumeration Date | 2016-06-09 |
Last Update Date | 2022-06-10 |