| NPI | 1538114863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 00030) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 38066) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME92390) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 21730) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2017-12-20 |