| NPI | 1760467005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 046803) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NV 15628) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036110696) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME84545) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OK 24145) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2018-01-05 |