| NPI | 1760793848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 56468) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 29161) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2015011442) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-38797) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD18674) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2022-12-07 |