| NPI | 1982803532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME101719) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 310629) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2023-09-26 |