| NPI | 1659584548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME100962) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 39916) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2021-12-16 |