| NPI | 1578756193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 2012003225) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD460332) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 0437506) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101256306) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WV 25867) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TN 51407) | |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2020-10-29 |