| NPI | 1730312224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25486) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 48380) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36811) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17451) | |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2022-12-15 |