| NPI | 1184856478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 74082) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD458034) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 284688) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 68124) | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2022-03-31 |