| NPI | 1194949883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0050215) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: KY 58835) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CO 50215) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2013-01685) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2024-02-15 |