| NPI | 1174841472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P8051) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 338501) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101257848) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX 549985) | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2024-05-10 |