| NPI | 1114333671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL L.4694SP) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0026407) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V2826) | |
| Enumeration Date | 2014-07-05 |
| Last Update Date | 2024-09-04 |