| NPI | 1538130588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME105621) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA L-224202) |
| Enumeration Date | 2006-01-29 |
| Last Update Date | 2022-02-11 |