| NPI | 1487629143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101242530) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 13472) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042-0011463) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2007-01079) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 041693) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-02-24 |