| NPI | 1285686766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 028509) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 19165) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 48081) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2022-08-05 |