| NPI | 1265404909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.10760R) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00021414) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 050849) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME85146) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 10760R) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2024-03-10 |