| NPI | 1659447118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2003008023) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0025652) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME93738) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-08-20 |