| NPI | 1073558383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301047552) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC ME110793) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2024-04-19 |