NPI | 1659467298 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2025026962) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX FTL 42713) |
2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q6834) | |
Enumeration Date | 2006-10-04 |
Last Update Date | 2025-08-18 |