NPI | 1578967469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME149712) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 7583) |
Enumeration Date | 2014-10-21 |
Last Update Date | 2024-01-05 |