| NPI | 1346534294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 27791) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 41676) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 57541) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-39564) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD18914) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2024-03-31 |