| NPI | 1578827044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 93975) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD21884) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2017010649) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2024-02-21 |