| NPI | 1992796478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101239549) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI 11753) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2022-01-24 |