NPI | 1053852384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 92316) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: GA 92316) |
Enumeration Date | 2017-03-20 |
Last Update Date | 2023-08-08 |