NPI | 1942863048 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V6881) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A182293) |
207R00000X Internal Medicine (Licence: TX V6881) | |
Enumeration Date | 2019-04-16 |
Last Update Date | 2025-05-12 |