NPI | 1639663891 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2024-00823) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101281313) |
2085R0202X Radiology, Diagnostic Radiology (Licence: SC 52709) | |
Enumeration Date | 2018-06-20 |
Last Update Date | 2024-07-01 |