| NPI | 1245290469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q1967) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 7715A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 23513) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 45694) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2022-07-28 |