NPI | 1548264211 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.05413R) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 05413R) |
2085B0100X Radiology, Body Imaging (Licence: LA 05413R) | |
Enumeration Date | 2005-06-09 |
Last Update Date | 2022-04-12 |