NPI | 1750310421 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 23679) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 20-23679) |
2085R0202X Radiology, Diagnostic Radiology (Licence: TX V2784) | |
Enumeration Date | 2006-07-03 |
Last Update Date | 2024-08-30 |