NPI | 1376003707 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 20A19929) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND PT22909) |
Enumeration Date | 2019-03-21 |
Last Update Date | 2025-09-23 |