NPI | 1366707564 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P4916) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME170629) |
Enumeration Date | 2012-07-13 |
Last Update Date | 2024-12-12 |