| NPI | 1609253533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0065453) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA A146596) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD21717) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-44350) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 33357) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2022-12-12 |