| NPI | 1467492355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0071765) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 155107) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MD D56123) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2023-11-02 |