| NPI | 1952634651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101256500) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 30986) |
| Enumeration Date | 2009-09-12 |
| Last Update Date | 2024-10-29 |