| NPI | 1225467681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI DO00946) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL UO3837) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS15299) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 285531) | |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2021-08-30 |