| NPI | 1629046040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME87670) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 51755) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2023-12-18 |