| NPI | 1255340949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.09984R) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME134839) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301087389) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 20547) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-04-25 |