| NPI | 1346536133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101252371) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101252371) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2023-07-07 |