NPI | 1780779892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2022-03033) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60085925) |
2085N0904X Radiology, Nuclear Radiology (Licence: OR MD164669) | |
2085N0904X Radiology, Nuclear Radiology (Licence: WA MD60085925) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD164669) | |
Enumeration Date | 2006-10-04 |
Last Update Date | 2023-07-13 |