| NPI | 1306824602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 97892) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 2021-01961) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2024-07-30 |