| NPI | 1275995482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0067722) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 69925) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WY 14477A) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NE 34298) | |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2022-07-28 |