| NPI | 1093730749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 43466) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A72891) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 7318A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 23277) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-41647) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD19873) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-12-09 |