| NPI | 1407072150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO 47515) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NE 23941) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WY 8287A) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IA 37821) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101242165) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME153374) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2023-07-31 |