| NPI | 1881670750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 037090) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 246191) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 33221) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2024-10-04 |