| NPI | 1396157996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042.0017710) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2019-00485) |
| Enumeration Date | 2014-05-30 |
| Last Update Date | 2024-09-14 |