| NPI | 1598743148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 27687) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL TPME4817) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2023-10-24 |