NPI | 1861943599 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: TX U5056) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U5056) |
2085B0100X Radiology, Body Imaging (Licence: TX U5056) | |
Enumeration Date | 2016-10-18 |
Last Update Date | 2023-09-21 |