| NPI | 1669797346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 308425) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0056434) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 308425) | |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2021-05-19 |