NPI | 1245214675 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101246165) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0053956) |
Enumeration Date | 2005-11-30 |
Last Update Date | 2020-01-27 |