| NPI | 1033183264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00022516) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU M-1810) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2023-07-26 |