| NPI | 1689794620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 37309) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 60512) |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2021-06-16 |