| NPI | 1356328975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042.0007498) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 305724) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2021-08-10 |