NPI | 1124550496 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2022-03341) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 10957022-1205) |
Enumeration Date | 2017-03-28 |
Last Update Date | 2024-09-25 |