NPI | 1356960108 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A201368) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA A201368) |
Enumeration Date | 2020-04-12 |
Last Update Date | 2025-07-02 |