| NPI | 1942434667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 69267) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 252116-1) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0060194) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2023-07-26 |