| NPI | 1831177310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 46083) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 6870) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2022-08-29 |