NPI | 1619917747 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C54828) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD164754) |
Enumeration Date | 2006-06-07 |
Last Update Date | 2025-09-19 |