NPI | 1750624144 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 82867) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 59250) |
2085R0202X Radiology, Diagnostic Radiology (Licence: CA A175662) | |
Enumeration Date | 2013-04-03 |
Last Update Date | 2023-08-07 |