| NPI | 1003878448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 29383) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25044) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36659) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI 17551) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2024-03-29 |