| NPI | 1801139142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 71626) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0068926) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 18192) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SD 13442) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60995806) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 68862-20) | |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2025-10-02 |