| NPI | 1780902593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q7548) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 004915) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2021-09-28 |