NPI | 1629031299 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0042796) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101239458) |
Enumeration Date | 2006-04-06 |
Last Update Date | 2023-08-04 |