| NPI | 1558604876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS15181) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 17114) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2020038652) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 074747) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 007458) | |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2025-11-13 |