| NPI | 1235300252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME158513) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 001583) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 43370) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NC 2011-00787) | |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2023-12-27 |