NPI | 1750366498 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A89966) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042-0011216) |
2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.201125) | |
Enumeration Date | 2005-12-14 |
Last Update Date | 2021-06-25 |