| NPI | 1669471660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 01302) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME0075779) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: GA 031654) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: SC 21356) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2017-12-20 |