NPI | 1114258191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0009846) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-54303) |
2085R0202X Radiology, Diagnostic Radiology (Licence: ND 17308) | |
Enumeration Date | 2010-01-15 |
Last Update Date | 2025-09-23 |