NPI | 1386133890 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 12701628-1205) |
Additional Taxonomies | 208800000X Urology (Licence: AZ R76739) |
208600000X Surgery (Licence: AZ R76739) | |
Enumeration Date | 2018-05-10 |
Last Update Date | 2022-02-15 |