| NPI | 1538192612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 57588) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 29694) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-39518) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD18957) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 058676) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2022-12-09 |