| NPI | 1497137327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 68135-20) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 6428-851) |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2021-08-05 |