| NPI | 1184872327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX BP10050938) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD476034) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301092794) | |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2023-10-20 |