| NPI | 1598023988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR C479763) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A126388) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61089913) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S4124) | |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2024-09-10 |