| NPI | 1659411080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 39413) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 24372020) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 51095) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SD 7936) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2011-12-19 |