| NPI | 1811916885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S0836) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA F5176) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX 45158) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME162567) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-01-08 |