| NPI | 1730445339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD.33272) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 325179) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2021-06-22 |