NPI | 1689672040 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 92993) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 24735) |
2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35063049) | |
Enumeration Date | 2005-07-11 |
Last Update Date | 2022-04-29 |