| NPI | 1235182106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 49229) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX L1130) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25811) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 83877) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2019-08-21 |