NPI | 1538458005 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2017-00888) |
Additional Taxonomies | 2085N0700X (Licence: TX S2573) |
2085R0202X Radiology, Diagnostic Radiology (Licence: KY 54590) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101265858) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD045027) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: TX S2573) | |
Enumeration Date | 2011-04-05 |
Last Update Date | 2025-08-12 |