NPI | 1669852844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A171343) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61038146) |
2085R0202X Radiology, Diagnostic Radiology (Licence: TX V3566) | |
Enumeration Date | 2015-06-03 |
Last Update Date | 2024-09-10 |