| NPI | 1740216449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 10819) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 15750) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 02682) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 9457) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 6606) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2007-07-08 |