| NPI | 1396724498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO 44778) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AK 5370) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: LA 025254) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 33681) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2023-03-07 |