| NPI | 1174556567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0034649) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IA MD-29931) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO Pending) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-29931) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2021-04-14 |