| NPI | 1215927579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 216714) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-16504) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 63484) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2024-05-16 |