| NPI | 1659467298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q6834) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX FTL 42713) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-11-13 |