NPI | 1780191684 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1022315) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD20743) |
Enumeration Date | 2018-01-02 |
Last Update Date | 2025-09-18 |