NPI | 1164411120 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0103729) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME164367) |
2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35066807) | |
Enumeration Date | 2005-10-20 |
Last Update Date | 2025-08-14 |