NPI | 1578099693 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD468600) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT213015) |
Enumeration Date | 2017-05-10 |
Last Update Date | 2023-02-26 |