NPI | 1811422777 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 66671) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301509343) |
Enumeration Date | 2017-04-27 |
Last Update Date | 2025-01-22 |