| NPI | 1255507463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NE 29956) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 2013005672) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-34252) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IA 44237) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2017-04-24 |