| NPI | 1811940380 |
|---|---|
| Former Name | JOSE MARCELO LLERENA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX K4488) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX K4488) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2021-08-25 |