| NPI | 1033236401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: HI 15021) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CO 57913) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NE 29853) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-39804) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA A90217) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2022-12-07 |