| NPI | 1861547317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 19293) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 58173) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-14168) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2024-05-16 |