| NPI | 1326240219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0051998) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CO DR.0051998) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D69276) | |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2019-05-30 |