NPI | 1760668156 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101263855) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 002839) |
2085R0202X Radiology Diagnostic Radiology (Licence: MD D0087760) | |
Enumeration Date | 2008-01-15 |
Last Update Date | 2021-09-13 |