NPI | 1528588621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 67313) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10061530) |
2085R0202X Radiology Diagnostic Radiology (Licence: AZ 65963) | |
Enumeration Date | 2017-06-21 |
Last Update Date | 2023-05-01 |