| NPI | 1043406242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0054946) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301089489) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2012019353) | |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2015-06-18 |