NPI | 1609371590 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61406159) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U2789) |
Enumeration Date | 2018-03-24 |
Last Update Date | 2024-08-29 |