| NPI | 1821555426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0069821) |
| Additional Taxonomies | 2085R0205X Radiology, Radiological Physics (Licence: WA ML60943648) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA ML60943648) | |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2023-06-12 |