| NPI | 1497753628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 15956) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 71541) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME120551) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 49627) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2017-12-20 |