NPI | 1750815171 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S3260) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A175634) |
Enumeration Date | 2017-04-12 |
Last Update Date | 2025-08-12 |