NPI | 1407046311 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 54301) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301084285) |
Enumeration Date | 2007-07-26 |
Last Update Date | 2025-07-30 |