| NPI | 1750523437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO CDRH.0055350) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R0923) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2024-09-12 |