NPI | 1164983078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME151737) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 83619) |
Enumeration Date | 2019-03-26 |
Last Update Date | 2025-08-14 |