| NPI | 1457538498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0055913) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NE 28871) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2024-03-31 |