NPI | 1891084869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME115064) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT212011) |
2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD43832) | |
Enumeration Date | 2011-03-30 |
Last Update Date | 2022-02-25 |