| NPI | 1386627206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 32476) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 53232) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2023-07-13 |