| NPI | 1851372866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0057534) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-31319) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TX N2148) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD19001) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NE 29763) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2024-03-29 |