| NPI | 1194799338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2017022028) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 23720AL) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-07-21 |