| NPI | 1518066604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042-0007139) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: VT 042-0007139) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2022-07-21 |