| NPI | 1194973735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD441702) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N4710) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2024-11-04 |