| NPI | 1417998774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR N7576) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 20491) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 11613) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-42462) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2022-08-16 |