| NPI | 1174521587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2010-01880) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME109048) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 34067) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0431008) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 048593) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2003018901) | |
| Enumeration Date | 2005-07-09 |
| Last Update Date | 2017-12-20 |