NPI | 1124017918 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 30401) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME160214) |
Enumeration Date | 2005-10-14 |
Last Update Date | 2023-09-29 |