| NPI | 1336533694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 1903) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101028317) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2024-11-26 |