| NPI | 1104058213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD.36376) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 56707) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 57686) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60479384) | |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2021-06-16 |