| NPI | 1487606323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00020013) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME81700) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 049537) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301058407) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2009-02-19 |