NPI | 1841586286 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0062732) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101019146) |
2085R0202X Radiology, Diagnostic Radiology (Licence: TN 2999) | |
Enumeration Date | 2011-06-23 |
Last Update Date | 2019-10-03 |