| NPI | 1851748057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 68569) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 74982-20) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD23089) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-46369) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 34719) | |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2022-12-07 |