| NPI | 1750384830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME90452) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 45283) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2024-06-12 |