| NPI | 1851359822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY TP350) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD426233) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX J1653) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2024-08-27 |