| NPI | 1295706950 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102050201) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS5985) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.009943) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 18413) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2020-07-08 |