| NPI | 1720280530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 1697) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0202207934) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2011032959) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS022903) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS11641) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 490) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2024-10-08 |