| NPI | 1578773032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 36394) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD29130) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 103216) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2025-04-04 |