| NPI | 1588082036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0067709) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 101280454) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2024-05-29 |