| NPI | 1174937072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0065499) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 008029) |
| 207R00000X Internal Medicine (Licence: IL 125-065537) | |
| 2085N0700X Radiology Neuroradiology (Licence: AZ 008029) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: HI DOS-2201) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 05-44958) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NE 2419) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2022-12-09 |