| NPI | 1780048447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD.MD.61672311) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A151509) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD222971) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0069229) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME106553) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2025-05-03 |