| NPI | 1851381826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 33969) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 1840) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2020-09-08 |