| NPI | 1225299092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 60010) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 053352) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT194738) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2020-09-09 |