NPI | 1275812489 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME151493) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q2237) |
Enumeration Date | 2011-08-05 |
Last Update Date | 2022-03-29 |