| NPI | 1487637427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 24561) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 29111) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2023-08-09 |