| NPI | 1407893795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 35956) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 42049-20) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036126457) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-11-21 |