NPI | 1568969160 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V0188) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101277873) |
Enumeration Date | 2018-04-10 |
Last Update Date | 2024-08-07 |