NPI | 1669652665 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.201618) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P1211) |
Enumeration Date | 2007-11-07 |
Last Update Date | 2023-03-07 |