| NPI | 1831383173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO 53729) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: AZ 46192) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD17657) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NE 27860) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-37164) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2024-03-29 |