| NPI | 1306937271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: AR E-2695) |
| Additional Taxonomies | 2085N0700X (Licence: WI 77529-20) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-2695) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2024-05-24 |