NPI | 1649763954 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 52604) |
Additional Taxonomies | 208600000X Surgery (Licence: SC LL52604) |
Enumeration Date | 2018-06-11 |
Last Update Date | 2023-08-08 |