| NPI | 1245420116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: MO 2012038362) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2012038362) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301507405) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 294363) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME158841) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2025-02-24 |