| NPI | 1649560731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 59963) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A143231) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD19673) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-40742) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 30587) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2023-01-24 |