NPI | 1235888520 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 74595) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 22680) |
Enumeration Date | 2022-03-22 |
Last Update Date | 2025-09-17 |