| NPI | 1699935064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2015014437) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-13387) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 5812) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0538184) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34011141) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2023-01-17 |