| NPI | 1821158171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO 45429) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: CO 45429) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD21074) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-43044) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NE 26237) | |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2022-12-13 |