NPI | 1417638628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ R4582) |
Additional Taxonomies | 208600000X Surgery (Licence: NE 9914) |
Enumeration Date | 2023-07-31 |
Last Update Date | 2025-08-08 |