NPI | 1285020982 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301508247) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 52813) |
Enumeration Date | 2015-04-09 |
Last Update Date | 2023-07-31 |