NPI | 1699334862 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A182251) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2019019244) |
Enumeration Date | 2019-06-11 |
Last Update Date | 2024-06-27 |