| NPI | 1528269784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 69222) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 059796) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2023-09-27 |