NPI | 1962963801 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 20A23020) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV DO3674) |
Enumeration Date | 2019-03-25 |
Last Update Date | 2025-03-11 |