| NPI | 1871609453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2007029596) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO T2004016409) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2022-08-19 |