| NPI | 1912968686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G81806) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0025584) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME141068) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2024-08-19 |