| NPI | 1720289200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 58625) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL DO.2358) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS11077) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2021-10-12 |