| NPI | 1326093998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: UT 180687-1205) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: LA 018094) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NV 9258) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2019-05-09 |