| NPI | 1730382821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 67312) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 28589) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC MD36307) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2019-05-06 |