NPI | 1750805917 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME168399) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX 45825) |
Enumeration Date | 2017-07-31 |
Last Update Date | 2024-10-28 |