NPI | 1811330145 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V1306) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0442267) |
2085R0202X Radiology, Diagnostic Radiology (Licence: CA A133800) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2019018888) | |
Enumeration Date | 2013-04-17 |
Last Update Date | 2025-09-11 |