NPI | 1366948721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V7079) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 58735) |
Enumeration Date | 2018-04-04 |
Last Update Date | 2025-05-21 |