| NPI | 1376906958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TX T3801) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: DE C2-0012271) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: ME DO3954) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-08-01 |