| NPI | 1609018399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD481440) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 232149) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2023-10-03 |