| NPI | 1679541817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 18098) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 74528) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2017-05-05 |