| NPI | 1003809567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0049439) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA OS010785L) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CO 51776) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA 20A10752) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2018-04-06 |