| NPI | 1851684120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0055006) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: CO DR55006) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2023-12-27 |