| NPI | 1265411011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101249852) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 4254) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2024-10-17 |