| NPI | 1023284312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME135033) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 58197) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 069105) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2024-01-16 |