| NPI | 1558317255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 31650) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36342) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI 17557) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25000) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2024-03-29 |