| NPI | 1528083276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 19434) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101006852) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 02001615A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 419) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-01-17 |