| NPI | 1063421295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042-0011386) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-8607) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 43235-020) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 19027) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX K1519) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2008-08-19 |