| NPI | 1205058849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0052855) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME108635) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 28842) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 10316A) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2018-05-23 |