| NPI | 1215375373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1018091) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S3004) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A135999) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2024-03651) | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2024-12-20 |