NPI | 1568099653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A200376) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA ML61169067) |
Enumeration Date | 2020-03-26 |
Last Update Date | 2025-09-10 |