NPI | 1619173721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM RS20070430) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU M-2334) |
Enumeration Date | 2007-06-25 |
Last Update Date | 2023-02-15 |