| NPI | 1487975579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0061043) |
| Additional Taxonomies | 2085N0700X (Licence: CO DR.0061043) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD20213) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-41529) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 31159) | |
| Enumeration Date | 2010-06-13 |
| Last Update Date | 2022-12-09 |