| NPI | 1730129859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 41619) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17450) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36694) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 24996) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2022-12-07 |