NPI | 1285691857 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: KY 28271) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101232453) |
Enumeration Date | 2006-04-27 |
Last Update Date | 2020-09-03 |