| NPI | 1457313314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 22159) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2005019089) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M9390) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 15088) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 9563A) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2023-12-28 |