| NPI | 1154421279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 53136) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 056425) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 38686) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 57718) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME143367) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-01-28 |