| NPI | 1427087816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 2023040724) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0055717) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2024-01-04 |