| NPI | 1811330145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V1306) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0442267) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A133800) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2019018888) | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2025-09-11 |