NPI | 1497174411 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61079462) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 65850) |
Enumeration Date | 2014-04-08 |
Last Update Date | 2024-09-03 |