NPI | 1851612782 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 12715) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 54206) |
Enumeration Date | 2010-06-15 |
Last Update Date | 2020-09-21 |