| NPI | 1184697831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101257776) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 12733) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2023-04-06 |