NPI | 1376633552 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 36212-020) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101228204) |
2085R0202X Radiology, Diagnostic Radiology (Licence: CA G73385) | |
Enumeration Date | 2006-10-16 |
Last Update Date | 2025-09-11 |