| NPI | 1033187927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 53966) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 9969A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 27947) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 42576-20) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2016-05-20 |