| NPI | 1669468526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 29192) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX K1996) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2023-03-16 |