NPI | 1558364158 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 20733) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME159935) |
Enumeration Date | 2005-05-27 |
Last Update Date | 2025-09-22 |