| NPI | 1720465396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A147782) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY TP674) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 54612) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 66468) | |
| Enumeration Date | 2015-05-02 |
| Last Update Date | 2023-03-31 |