| NPI | 1750385357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 15891) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MTL-2023-028) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 11756C) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 15495) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2018035939) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MC-198) | |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2023-12-28 |