NPI | 1235129958 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME157552) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX J2643) |
Enumeration Date | 2005-10-25 |
Last Update Date | 2023-04-04 |