NPI | 1669679569 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS15940) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 20A20771) |
2085R0202X Radiology, Diagnostic Radiology (Licence: TX P0069) | |
Enumeration Date | 2007-07-03 |
Last Update Date | 2025-09-25 |