| NPI | 1073583068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 20633) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME111929) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G87080) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2024-05-16 |