| NPI | 1518946649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 107457) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME102813) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NM TM2005-0701) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04 28109) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2024-04-19 |