NPI | 1104275528 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 39669) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC LL39669) |
2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2021-02770) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101273384) | |
Enumeration Date | 2016-06-07 |
Last Update Date | 2025-10-02 |