NPI | 1508217050 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A172762) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R10617) |
Enumeration Date | 2016-06-27 |
Last Update Date | 2021-07-01 |