NPI | 1184621021 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 17131) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 329611) |
2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042.0016510-COMP) | |
Enumeration Date | 2005-07-07 |
Last Update Date | 2023-08-24 |