NPI | 1871090415 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301507064) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 98807) |
Enumeration Date | 2018-04-10 |
Last Update Date | 2025-09-07 |