| NPI | 1447249495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200100541) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 11941) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2024-10-14 |