NPI | 1205272408 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 90901) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 191928) |
2085R0202X Radiology, Diagnostic Radiology (Licence: TN 56340) | |
Enumeration Date | 2013-05-14 |
Last Update Date | 2022-06-09 |