| NPI | 1114144417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 76362) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 24512) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 55898-20) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-33132) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2023-03-20 |