NPI | 1104872837 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA C141328) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101244741) |
Enumeration Date | 2006-05-25 |
Last Update Date | 2025-06-25 |