| NPI | 1588872303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 49147) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125-048361) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17510) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25774) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36352) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2024-03-31 |