NPI | 1952725178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 27444) |
Additional Taxonomies | 208D00000X General Practice (Licence: NE 28908) |
2085N0700X Radiology, Neuroradiology (Licence: ND 18138) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: TX S0343) | |
Enumeration Date | 2014-02-07 |
Last Update Date | 2024-05-23 |