| NPI | 1538185012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: LA MD.06280R) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 06280R) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2024-09-30 |