| NPI | 1821445107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0067900) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 69923-20) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 14443A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 34351) | |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2022-07-27 |