NPI | 1750519815 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: LA 306950) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AL 34351) |
Enumeration Date | 2009-06-29 |
Last Update Date | 2017-11-10 |