| NPI | 1689831836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 53515) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 27758) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 253324) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 239534) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17656) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-37061) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2022-12-12 |