| NPI | 1952386419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 24666) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 8684) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2019-02-06 |