| NPI | 1437390499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 27887) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 207255) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2021-04-29 |