| NPI | 1518946649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61076280) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM TM2005-0701) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04 28109) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME102813) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 107457) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0025717) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2025-10-02 |