NPI | 1952892911 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301511229) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4351027654) |
2085B0100X Radiology, Body Imaging (Licence: IL 125.081136) | |
Enumeration Date | 2018-05-25 |
Last Update Date | 2024-08-16 |