| NPI | 1437360567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 45746) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 23814) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2022-02-04 |