| NPI | 1528232295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25423) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 49042020) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 38361) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0434048) | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2016-04-22 |