| NPI | 1053350298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA md019457) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL me165308) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-11-02 |