NPI | 1992989859 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T4163) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX 41997 Temporary) |
Enumeration Date | 2007-12-27 |
Last Update Date | 2021-11-17 |