| NPI | 1447296777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101014880) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 03980) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS13470) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2022-11-14 |