| NPI | 1720053036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0050837) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME104506) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 47684) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 8908A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 26628) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2025-07-01 |