| NPI | 1366903163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A181200) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME177239) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036177704) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 110273) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0076790) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2026-01-27 |