NPI | 1801175401 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2010018032) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU DOC-032) |
2085R0202X Radiology, Diagnostic Radiology (Licence: ND 19896) | |
Enumeration Date | 2011-08-12 |
Last Update Date | 2024-10-14 |