| NPI | 1659440774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 34299) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2023-03-07 |