| NPI | 1184793226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 074019) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD12803) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 156625) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2019-05-03 |