NPI | 1104111608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD044237) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD487664C) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0081921) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: TN 71815) | |
Enumeration Date | 2011-06-13 |
Last Update Date | 2025-07-22 |