| NPI | 1194927160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE 2085R0202X) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD446176) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2019-05-23 |