NPI | 1376551671 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 34846) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2020011812) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2021-06-29 |