| NPI | 1588828941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 62136) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A119484) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2013-01207) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD.29379) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2021-01-11 |