| NPI | 1447605704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD474970) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME166355) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2024-03-04 |