| NPI | 1225182231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101241249) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 053204) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2022-01-19 |