| NPI | 1417051145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD471642) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 35261) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 11194) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2022-07-14 |