| NPI | 1538497300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 072446) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TN MD0000045447) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MN 105525) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MN 54577) | |
| Enumeration Date | 2009-12-06 |
| Last Update Date | 2016-11-22 |