| NPI | 1194773549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 9801558) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0025587) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U3055) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2024-08-20 |