| NPI | 1396940342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: FL ME103607) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 045245) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0026953) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2024-08-20 |