| NPI | 1669444246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P4581) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 32876) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 16211) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 12513C) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2022-10-18 |