| NPI | 1033503990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 1544) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 203231) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2024-03-12 |