| NPI | 1942283205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX H4679) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 19355) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2024-11-25 |