| NPI | 1366429383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TX J8225) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 24893) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: DE C1-0025633) | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2024-08-19 |