NPI | 1154367878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2022-1266) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 49550) |
Enumeration Date | 2006-06-21 |
Last Update Date | 2022-09-16 |