| NPI | 1356516298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 88334) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 128226) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2022-01-18 |