| NPI | 1699806265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 108640) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY IP874) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2009009701) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 43801) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-14 |