| NPI | 1437248523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME102659) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL TRN9098) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2022-08-16 |