| NPI | 1780883835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 53610) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD18394) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A110622) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 27901) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-37256) | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2017-04-07 |