| NPI | 1487826624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME124760) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 046203) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2020-09-29 |