| NPI | 1477932432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 62936) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ R75043) |
| Enumeration Date | 2015-05-23 |
| Last Update Date | 2024-06-10 |