NPI | 1093200966 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 73906) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2019018206) |
2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101278132) | |
Enumeration Date | 2018-06-24 |
Last Update Date | 2025-07-08 |