NPI | 1518349570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME158901) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T8643) |
Enumeration Date | 2015-06-25 |
Last Update Date | 2025-09-15 |