| NPI | 1841459039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 99624) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD 60011762) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 239573) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2023-04-12 |