| NPI | 1477564094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TX J8332) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A53253) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 47346) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2024-04-22 |