NPI | 1083989362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0065457) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 13302A) |
2085R0202X Radiology, Diagnostic Radiology (Licence: TX R7944) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: NE 33216) | |
Enumeration Date | 2012-03-20 |
Last Update Date | 2021-06-05 |