| NPI | 1427411545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0067642) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 14431A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 12210709-1204) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 2540) | |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2022-07-28 |