| NPI | 1326010356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 22619) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TX T1430) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: DE C1-0025586) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2024-08-19 |