| NPI | 1578927539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2022-01892) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A171311) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1016138) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 56787) | |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2024-11-19 |