| NPI | 1225487903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 91813) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC RTL21-0032) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2022-05-06 |