| NPI | 1225083942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 18490) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI EMC0006070) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2024-12-04 |