| NPI | 1710942172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 35792) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 50784) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 40906) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2023-08-09 |