NPI | 1508815978 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD12005) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D61496) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MA 261389) | |
Enumeration Date | 2006-05-10 |
Last Update Date | 2024-03-15 |