| NPI | 1598738577 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 20484) | 
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: WI 39748021) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 121212222211) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 5638) | |
| Enumeration Date | 2006-02-09 | 
| Last Update Date | 2023-06-14 |