NPI | 1770544348 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 005354) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 5/31/2006) |
Enumeration Date | 2006-03-31 |
Last Update Date | 2023-07-17 |