| NPI | 1669961835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-17830) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 11414344-1205) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301509538) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD219631) | |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2024-08-01 |