| NPI | 1629205042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0054939) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-43485) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD21076) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NE 28578) | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2022-12-07 |