| NPI | 1336358233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 26769) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 55758) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 40272) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SD 8376) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2018-09-25 |