| NPI | 1740244011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 61543) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0081760) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 284287) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00043485) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 46106) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2024-03-31 |