| NPI | 1033373287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A100569) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301108735) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME142683) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0025770) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2024-08-23 |