NPI | 1578850053 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D81529) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9407696) |
2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.206142) | |
Enumeration Date | 2011-07-05 |
Last Update Date | 2021-09-16 |