| NPI | 1518281781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 44183) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 53459) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2021-11-05 |