| NPI | 1053601757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME164130) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 077038) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 26607) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 55279) | |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2025-01-16 |