NPI | 1780689497 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301407066) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME151232) |
Enumeration Date | 2005-06-17 |
Last Update Date | 2022-05-03 |