| NPI | 1841673712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME151021) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD d84015) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2023-03-20 |