| NPI | 1598025561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0063435) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD P27664) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-44346) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60600843) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 11487A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 35191) | |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2022-12-06 |