| NPI | 1134127830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME89675) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: FL ME89675) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 57181) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2023-12-19 |