| NPI | 1134193980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME74950) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2010038795) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-21831) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2023-11-03 |