NPI | 1710913975 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.022262) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 16495) |
Enumeration Date | 2006-06-22 |
Last Update Date | 2021-09-27 |