| NPI | 1033479233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 35786) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 57012) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2023-08-10 |