| NPI | 1518370113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: WY 15422A) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NE CP568) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TX R8879) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CO CDR.0003602) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2024-06-17 |