| NPI | 1043311202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 25726) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 36500) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0073191) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 16969A) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2024-08-16 |