| NPI | 1144460619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101261623) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 237986-1) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 062450) | |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2022-01-10 |