NPI | 1831325372 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NC 2014-00832) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2009013721) |
2085R0202X Radiology, Diagnostic Radiology (Licence: TN 55686) | |
Enumeration Date | 2009-06-10 |
Last Update Date | 2022-07-21 |