| NPI | 1598738577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA 20484) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: WI 39748021) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WI 121212222211) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 5638) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2023-06-14 |