NPI | 1245205715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: AZ 52367) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P3457) |
Enumeration Date | 2006-02-20 |
Last Update Date | 2025-01-27 |