| NPI | 1013438266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 15461A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE CP542) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO CDR.0003788) | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2024-06-17 |