| NPI | 1740241660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 39231) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 05-36547) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI DOS1581) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 672) | |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2019-07-30 |