NPI | 1285717389 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A90996) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TX R8853) |
2085R0202X Radiology Diagnostic Radiology (Licence: CT 66308) | |
Enumeration Date | 2006-10-23 |
Last Update Date | 2024-09-10 |