| NPI | 1942397922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 23698) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 27972) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2023-03-10 |