| NPI | 1295759223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 16601) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00014743) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2006-00770) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 057907) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-05-29 |