| NPI | 1487838249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 067951) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301101952) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 246300) | |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2024-02-21 |