| NPI | 1023279767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 42567) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 18271) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2025-05-06 |