NPI | 1487035812 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 77519) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 87005) |
Enumeration Date | 2015-06-11 |
Last Update Date | 2025-09-17 |