| NPI | 1538114756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN 24640) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CO 44220) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MO 111288) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WA 60137247) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KY 31145) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NM TM2008-0056) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WY 8957A) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2013-03-26 |