NPI | 1578183018 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 104593) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX BP10074422) |
Enumeration Date | 2020-04-24 |
Last Update Date | 2025-06-03 |