| NPI | 1285039453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0065802) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: CO DR.0065802) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OR DO208579) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KY IP1529) | |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2024-04-19 |