| NPI | 1649256561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 23198) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25104) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36688) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17507) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2022-12-14 |