| NPI | 1861453789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 39211) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 22599) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-29840) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17524) | |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2024-03-29 |