NPI | 1285171405 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2020004310) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61318617) |
Enumeration Date | 2017-01-25 |
Last Update Date | 2024-08-30 |