| NPI | 1346305653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD448232) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 15201) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0070398) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042-0011924) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-17 |