| NPI | 1003802968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 34173) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 34173) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2018011357) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 11738C) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MTL-2023-030) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 16510) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU M-2422) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2024-01-31 |