| NPI | 1982684338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WI 28478-020) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 28478-020) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2019-06-11 |