| NPI | 1417113366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 54606) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 9940A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 28274) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-115772) | |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2015-09-16 |