NPI | 1225666472 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1022427) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME156262) |
Enumeration Date | 2020-03-31 |
Last Update Date | 2025-06-04 |