| NPI | 1225076219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME141810) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 6776) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101244214) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2023-08-04 |