| NPI | 1184935983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101250174) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME161169) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA A156017) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NC 2023-00962) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2024-01-05 |