| NPI | 1235344011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME111431) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 26192) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2023-09-27 |