| NPI | 1366609653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 46616) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36301) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17494) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25107) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2024-03-31 |