| NPI | 1073584132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 44114) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL DO.3495) |
| 208D00000X General Practice (Licence: GA 44114) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2024-01-19 |