| NPI | 1568435717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A70061) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD27699) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 25060) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2006-01622) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2023-12-19 |