| NPI | 1538335179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME136973) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL L.3423SP) |
| Enumeration Date | 2008-05-04 |
| Last Update Date | 2020-09-01 |