| NPI | 1073561510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI EMC0005770) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 2941) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2025-01-02 |