NPI | 1104848506 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 02002431A) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0053540) |
2085R0202X Radiology, Diagnostic Radiology (Licence: KY 02983) | |
Enumeration Date | 2006-07-24 |
Last Update Date | 2022-03-25 |