NPI | 1508015207 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2022-1142) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME111493) |
Enumeration Date | 2008-09-17 |
Last Update Date | 2022-09-12 |