| NPI | 1184678369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 12293) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 5211240-1205) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2024-04-02 |