NPI | 1780661280 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 38372) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 47062) |
Enumeration Date | 2005-12-27 |
Last Update Date | 2021-02-24 |