NPI | 1518123041 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60335345) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 5757) |
2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 45752) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-23897) | |
Enumeration Date | 2008-08-04 |
Last Update Date | 2023-09-21 |