NPI | 1518385384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 41001) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME140672) |
Enumeration Date | 2014-03-30 |
Last Update Date | 2025-01-07 |