| NPI | 1114380433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1020017) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D85885) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2024-05-23 |