| NPI | 1598021305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME153659) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD463820) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 125060804) | |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2024-04-03 |