| NPI | 1295095842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102208183) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 04061) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 90104) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 318570) | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2024-01-09 |