| NPI | 1245729342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A184649) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 48587) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME144147) | |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2024-06-06 |