NPI | 1164460358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60320843) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI EMC0001580) |
Enumeration Date | 2006-06-02 |
Last Update Date | 2025-01-28 |