| NPI | 1427033158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME91826) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 217425) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 233652) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 33176) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2021-07-06 |