| NPI | 1447342886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 025830) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME81865) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2023-03-07 |