| NPI | 1447239389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 34928) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME124304) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN md34142) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2021-06-09 |