| NPI | 1801854732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME110178) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 41695) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 11409) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 213739) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 62818) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2022-07-01 |