| NPI | 1023026234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 31004) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME87255) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A81730) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2024-02-29 |