| NPI | 1477733574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61582833) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 6351865-8905) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2024-10-23 |