NPI | 1831641455 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0904X Radiology Nuclear Radiology (Licence: VA 0101265957) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101265957) |
Enumeration Date | 2016-10-31 |
Last Update Date | 2020-10-19 |