| NPI | 1548231301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 82568) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 209598) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2024-07-10 |