| NPI | 1710281654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD H72120) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS014793) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C2-0008715) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC DO034339) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102202856) | |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2015-09-03 |