| NPI | 1457567166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 66024) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 24973) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD0000045729) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2022-01-07 |