| NPI | 1114239126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2016-01364) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 173412) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2020-09-03 |