| NPI | 1477647998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: ID M-12877) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NV 12448) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01058095A) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA 129014) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WY 10128A) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2016-10-11 |