| NPI | 1992951651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 44675) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0055175) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME140226) | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2022-01-26 |