| NPI | 1841298262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.023592) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 023592) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 19262) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 27613) | |
| Enumeration Date | 2005-07-09 |
| Last Update Date | 2015-08-14 |