| NPI | 1578749990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0056049) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 070206) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NC 2015-02370) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 51465) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-38613) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OK 31915) | |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2016-02-03 |